Letter of Assent Request Form

Letter of Assent Request Form

Company Name:
Company Address, City, State and Zip:
Federal Employer Identification No:
Contact Name:
Contact Number:
Contact Email:
Primary Payroll Contact Name:
Primary Payroll Contact Email:
Primary Payroll Contact Number:
Are you currently signatory with any IBEW Local?	NOYESCHOOSE ONE
If you are currently signatory with an IBEW Local, please list which IBEW Local(s)
Does your company have current work in our area?
Is the current work storm related or regular work?
Type of letter requesting:	Not SureCBACHOOSE ONE
Comments:
	Enter the text shown in the image above.